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Background: Hypertension, an important risk factor for non-communicable diseases and highly prevalent in South Africa and other African countries, exerts a substantial burden of disease. Prevalence estimates in African countries range from 40% to 60%, and this high prevalence in resource-limited communities raises sustainability questions regarding long-term treatment using expensive medications. Lifestyle modifications such as dietary changes, increased physical activity and exercise can be employed to reduce hypertension.

Objectives: To conduct a Cochrane systematic review to assess the benefits and harms of home and community-based exercise interventions for the prevention and treatment of hypertension as applicable to low-resource settings.

Methods: Randomised trials examining the effects of exercise or physical activity for treatment or prevention of hypertension will be included. Home and community-based interventions will be included, whereas supervised interventions and those in resource-intensive settings (e.g. universities and laboratories), will be excluded. Primary outcomes will be changes in blood pressure and mean arterial pressure. Adverse events and use of anti-hypertensive medication will be secondary outcome measures. Several key stages of the review, including checking all titles and abstracts identified from electronic databases and other searches, assessing eligibility of retrieved studies for review according to the inclusion criteria, grading quality, identifying risk of bias, and extracting data from included studies, will be undertaken by two reviewers independently. Disagreements will be resolved by consensus with reference to the a priori protocol. Adverse events will be measured as the number of patients experiencing any adverse event and serious adverse events, as well as patients who withdrew or dropped out because of adverse events. Where possible, analyses will be conducted on intention-to-treat data. Missing data will be sought from study authors, or imputed if actual data cannot be retrieved. Results will be grouped by intervention, and recommendations made for application in low-resource settings.